Comparative Study on Analgesic Efficacy and Early Knee Function of Femoral Nerve Block and Adductor Canal Block after Tibial Tuberosity Osteotomy Combined with Medial Patellofemoral Ligament Reconstruction / 中国运动医学杂志

ABSTRACT

Objective To compare the analgesic effect and early function of adductor canal block(ACB)and femoral nerve block(FNB)after tibial tuberosity osteotomy and medial patellofemoral liga-ment reconstruction.Methods Forty-two recurrent patellar dislocation patients to undergo tibial tuberosi-ty osteotomy and medial patellofemoral ligament reconstruction in Beijing Jishuitan Hospital between February 2019 and September 2021 were selected and randomly divided into an ACB group and an FNB group,each of 21,according to a random number table.The ACB group underwent adductor ca-nal block,while the FNB group received femoral nerve block.Then the postoperative analgesic effect,joint range of motion,quadriceps muscle strength and functional recovery were evaluated and com-pared between the two groups.Results The average visual analogue scale scores of the ACB group at rest and exercise were 5.5±1.6 and 6.1±1.6,significantly better than the corresponding values of the FNB group(6.3±1.8 and 6.9±1.8)48 hours after surgery(P<0.05).However,no significant dif-ferences were found between the two groups in this value 12 and 24 hours after surgery.Moreover,12 and 24 hours after surgery,the quadriceps muscle strength of the ACB group was significantly bet-ter than the FNB group(P<0.05),while there were no significant differences between the two groups 48 hours after the surgery.The time required for the maximum knee flexion angle to reach 90° was 2.8±0.5 days in the ACB group,significantly shorter than 4.2±0.6 days of the FNB group(P= 0.018).Conclusion For recurrent patellar dislocation patients undergoing tibial tuberosity osteotomy com-bined with medial patellofemoral ligament reconstruction,adductor canal block may be superior to femo-ral nerve block in terms of preserving quadriceps muscle strength and early restoration of knee joint range of motion.